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Hayhurst ’21: EMT for the Crawfordsville Fire Department

Neal Hayhurst ’21 — This summer, I had the opportunity to work as an EMT for the Crawfordsville Fire Department. First, I would like to thank Jill Rogers for organizing this for me and the Global Health Initiative for covering my housing costs. The time, effort, and money they have dedicated to me embodies the Wabash spirit and reminds me why I chose to attend this special college.

As an EMT, you meet people where they are. Patients don’t shower, dress up, and drive over to the clinic to receive the treatment we give. Patients sometimes need treatment in the middle of the road, in their car in a parking lot, or on the floor of a bathroom. These are all situations that I encountered this summer which required me to meet patients where they were. I guess you could say that our goal was to meet every patient at the starting point—whatever state of need they are in–and get them to our end point- the hospital in a stable or improved condition. The complicating part—the emergency part of emergency medicine–is that the EMT never knows what the starting point may be, which means it may be harder or take longer to get some patients to the end point and easier and more straightforward for others. Whether the patient is a man bleeding and in pain in the road, a man seizing in his car, or a lady who has fallen in her bathroom, we see each and every patient as deserving of our best work and our best effort to get them to the same endpoint. EMTs meet these people at their worst, their most vulnerable, and do what they can to heal.

The interpersonal connection between an EMT or paramedic and their patient is often just as important as a well-developed knowledge of emergency care. One of the paramedics that I worked with this summer told me that if you talk to a patient long enough and are truly interested in their story, they will tell you exactly what is wrong with them. I found that to be especially true in the context of older patients who can quickly become annoyed with poking and prodding and tests. It is so easy to become obsessed with data and the cold hard numbers and to consequently miss the easiest way, both for the patient and the care provider, to uncover the problem. It was fun to put the EMT skills I had learned into practice, but I think interacting with patients and learning how to connect with them and earn their trust was the most beneficial part of the whole experience for me as an aspiring physician.


Equihua ’20 — What is it you want to do, again? Primary care? Pick something else

Artie Equihua ’20

Artie Equihua ’20 — When I was around three or four years old, I told my grandfather I wanted to be a scientist. This statement did not evoke the greatest response considering he probably wanted (and still wants) me to pursue a career in professional sports. However, my fascination with science and deep desire to help those who feel hopeless has crafted my current dream of becoming a physician. However, even a kid who has dreamed of working in healthcare for his entire life can become overwhelmed by the negativity associated with it. Most recently, I had a discussion with a primary care physician working out of North Carolina. In our conversation he mentioned he had always wanted to be a doctor because of his love for science and his ability to utilize it in order to help people, but the current system was not allowing him to care for his patients to the extent he wanted to. Shortly after this comment he looked at me and said, “Healthcare is going to hell. What is it you want to do, again? Primary care? Pick something else.”

This encounter with the primary care physician had truly shook me. How could someone with such similar aspirations become so depressed and resentful toward healthcare? I tried to formulate a response that would somehow change the subject, and I ended up blurting out what his statement had made me feel. I started with the story involving my grandpa. I explained how I had identical interests and why I wanted to become a physician, but I did not say I agreed with his current perspective. Instead, I explained that I often, too, feel very cynical about the industry that I hope to someday find a career in; however, there is so much innovation and change already occurring that it keeps me hopeful.

Unfortunately, I could tell that he had not changed his position on the matter. Perhaps, he believes me to be naive, but I can live with that. Fortunately for me, with each new daunting flaw that I hear about in healthcare, I am exposed to the innovative work of twice as many people who are dedicating their lives to solving current healthcare issues on all levels. With so much innovation and optimism radiating from individuals at Volunteers in Medicine, HealthLINC, NCHICA, DHIT, Duke, UNC, and many other organizations, it is hard not to feel hopeful for the future.

This summer Equihua is participating along with Nathan Gray in a Global Health Initiative internship with Wabash alumnus Dr. Todd Rowland (www.bridge2medical.com). This is his second blog post in the series of posts on exploring the world of health care and those trying to revolutionize it. The G. Michael Dill Fund makes this internship possible.


Equihua ’20 – A Liberal Arts Perspective of Digital Health

Nathan Gray ’20, Dr.Todd Rowland ’85, Dr. Raj Haddawi, Arthur Equihua ’20. Dr. Haddawi helped found the Monroe County Volunteers in Medicine (VIM) Clinic in Bloomington in 2007, raising nearly $1 million in donations from the local community and engaging 200+ physicians in a volunteer effort. He now lives in Chapel Hill and was happy to meet with the students.

Artie Equihua ’20 — This summer I am fortunate to participate in a Global Health Initiative internship with Wabash alumnus Dr. Todd Rowland (www.bridge2medical.com) with my fellow intern Nathan Gray.  This is the first of series of blog posts where I provide an update to the larger community. I would like to thank the G. Michael Dill Fund for making this internship possible.

This past week I had the privilege of observing a health information exchange called HealthLINC, in addition to, medical and business professionals at the Volunteers in Medicine (VIM) Clinic in Bloomington, Indiana. From observing these two organizations, I was able to see how the integration of technology affected the organization of the clinic and level of care provided to patients.

A common trend I had observed while I was at the VIM clinic was the large number of prescribed medications each patient was taking from multiple physicians. As it turns out, one third of Medicare spending is on patients which have five or more chronic conditions and see an average of fourteen different physicians annually (1). On top of that, those with 5 or more chronic conditions are prescribed an average of 50 prescriptions a year (2). Thus, if a patient is prescribed medications from multiple different doctors, do all of the doctors communicate? How do they keep track of every medication prescribed to the patient? Unfortunately, the answer to the first question is most likely no. These are the questions that are currently being answered by innovative healthcare technology known as digital health. Luckily for the VIM clinic, HealthLINC provides a digital health software system called Med Management which enables physicians and other medical staff to input and track each drug prescribed to their patients, instead of relying on the patient to recite their entire medical list. Thus, the increased efficiency created by the integration of technology systems such as med management, enabled more personalized care than before.

Overall, my experiences with Volunteers in Medicine and HealthLINC has been both insightful and thought provoking. In just a week, I have established a much better sense of what a functional clinic needs in order to sustain its level of care and office efficiency. Yet, the knowledge gained from my experiences has only exposed more dimensions of the healthcare industry that I still need to explore.

Sources:

CBO Budget Options, Volume 1: Health Care. December 2008.
U.S. Department of Health and Human Services (2010). Multiple Chronic Conditions – A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions. Washington, D.C. December, 2010.


Gray ’20 – Your Doctors Aren’t Talking About You—And That’s a Problem

Nathan Gray ’20 — This summer I am fortunate to participate in a Global Health Initiative internship with Wabash alumnus Dr. Todd Rowland (www.bridge2medical.com) with my fellow intern Artie Equihua. This is the first of a series of blog posts where I share my experiences and observations about the healthcare field. I would like to thank the G. Michael Dill Fund for making this valuable opportunity possible.

During my week in Bloomington, I had the pleasure to shadow many of the staff at HealthLINC, a health information exchange, and at the Volunteers In Medicine (VIM) Clinic of Monroe County which provides care for the medically underserved. As I learned, in a healthcare system as fragmented as ours, a patient can quickly rack up a laundry list of medical care providers, and the failure of providers to coordinate their care can be deadly. Medical errors may result in as many as 251,000 deaths in the U.S. each year, making it the third leading cause of death in the country.1 Coordinating care and patient medical records across providers is critical to challenging this unacceptable statistic.

Health information exchanges, like HealthLINC, are playing an essential role in this battle by developing tools that aggregate a patient’s data into more complete and accessible records for all the providers using the tool. Sitting-in on a staff meeting and a conference call with their software developer provided Artie and I a unique peek into how these tools are developed, and my time at the VIM Clinic, which uses HealthLINC’s tools, demonstrated their important use.

The dedication of the VIM staff to their mission and the empathy with which they treated everyone who came into the clinic was an astounding sight. In my time at the clinic, I was inspired by an approach to medical care that was truly focused on improving patient outcomes of wellness—not only through clinical treatment but also by tackling the behavioral and social determinants of health whether that be overcoming language barriers, lifestyle counseling, or accessing social services. In carrying out their work, the VIM staff make effective use of digital health tools to the betterment of their patients.

Finally, a visit to the Critical Access hospital in Paoli, Indiana exposed me to the challenges for rural populations to access medical care. Critical Access is a designation given by the government to hospitals which serve rural populations and meet a number of other requirements. Critical Access hospitals, and especially their 24/7 emergency departments, are often an essential provider of care to these communities. Rural populations have greater difficulty accessing affordable medical care than their urban counterparts due to the limited supply of rural healthcare providers and other obstacles like transportation. It seems many now rely on the emergency departments of these hospitals as their primary care providers. This causes financial strain on the hospitals, is non-ideal for long term patient care, and if proper information systems are not in place, larger hospitals to which patients are transferred, may lack access to their patients’ complete medical records.

My experiences highlighted how various groups are working to reduce disparities in access and quality of care for the medically underserved and the important role that coordinated care plays in improving patient outcomes. In the coming weeks, I look forward to gaining a better understanding of the different actors involved in our healthcare system and how they are responding to changes in the industry of healthcare in innovative and patient-centered ways. A special thanks to Kathy Church from HealthLINC, the VIM Clinic staff especially Ed Hinds, and Sonya Zeller from IU Health Paoli for their time and effort in making this week so valuable.

1.         Anderson, JG; Abrahamson, K. “Your Health Care May Kill You: Medical Errors” Stud Health Technol Inform. 2017